Cannabis abuse and spinal Anesthesia-A case series

Abstract

Background: Cannabis abuse is very common in our society and it is not uncommon to encounter patients abusing these drugs to come for surgery under Anesthesia. Cannabinoid compounds act on cannabinoid receptors CB1 and CB2 which are present in different locations in the body including the spinal cord, thereby interfering with anesthetic effect of various drugs such as inhalational, intravenous and local anesthetics. Cases: In this case series, we report six cases of subarachnoid block (SAB) failure in cannabinoid abusers. There was delayed onset, patchy effect and decreased duration of both sensory and motor block among these abusers, with increased requirement for supplementation with analgesic or anesthetic drugs or conversion to general anesthesia (GA).Conclusion: Alternative to SAB such as regional nerve blocks or GA should be the considered in these abusers. If at all SAB is administered, conversion to GA should be kept as a ready option.